You’d be surprised by this but there are doctors who honestly don’t find any problem with the government forcing poor people and pensioners to pay $6 out of pocket for GP visits. Or forcing everyone to pay $300 out of pocket for specialist appointments.

There are plenty of people who need to see their doctor 3 times a week and are too sick or old to work. For these people, $20 a week is a lot of money. They are being punished for being sick. $300 is also 1.5 weeks worth of dole or pension money. What happens if you need to see more than one specialist?

The answer is that you don’t go to your doctor. You just turn up to emergency in extremis.

The evidence is clear about these things: not only does this sort of nonsense make society sicker, it is also incredibly cost-ineffective. Just look at the US, the most inefficient and backwards health system in the “developed” world. 16.5% of GDP in government spending for what are inexcusably shit health outcomes. Then there’s Japan which spends half that percentage – about 8% of GDP – with one of the top 5 outcomes in the world! The bottom line is that an accessible and well organised public health system has benefits for all – including the rich.

So this stuff – health economics and sociology – is compulsory material in med school. It’s appalling then, to see doctors complain that “the poor” spend “all their money on junk” and that they should all be spending on exorbitant medical fees instead.

I’ve had community members – all employed – tell me that they think the AMA is guilty of anticompetitive collusion with those sorts of AMA suggested rates for private doctors’ fees. The community perception is that when it comes to out of hospital costs they are being screwed.

And they are. In most states, there is no public outpatients service. Outside major cities, there are no bulk billing GPs. Patients’ only choice is seeing a private GP – often charging $75 in total (Medicare rebates $40 of this) per consultation – and private specialists who usually charge $200 or more out of pocket. GPs at least will often bulk bill the poor (healthcare card holders), children and pensioners. But with the $6 “copayment” this discretionary service is now a tax on the poor. It’s appalling.

And yet despite the fact that patients will be sicker, GP practices will lose significant business and emergency departments (already overwhelmed) will be overrun, there are doctors who continue to insist that this is somehow a “good” or “necessary” move. Necessary for whom? For doctors who have 10 mortgages that they’re negative gearing and renting at ridiculous rates as property developers and yet can barely afford to pay for? For members of the Liberal and Labor Party who are already scamming money from public coffers? It makes me sick.

People who have never had to struggle a day in their lives, who grew up with a silver spoon in their mouth, who were spoon-fed all through private school, who were the entitled descendents of generations of “doctor families”, of course “born to rule” and who met their first poor (or lower middle class) person as a medical student and were horrified by their “lack of breeding”, their coarse words and unfashionable clothing, their disgusting teeth and awful health, their lack of refinement and their inability to understand medical terms.

Are these my colleagues? This sort of attitude makes me ill.

You know what I hope happens to them? I wish upon them an efficient public system and outpatients, enough doctors and nurses, rural coverage with public subspecialists, bulk-billing GPs and a government that supports the public sector. I wish them a future where they can’t possibly compete in the private sector and where patients refuse to accept being talked down to. I wish them adequate competition and adequate public jobs. I wish them healthier, happier patients. I wish them being forced to live through the “horror” of health equity.

And most of all I wish them no more fucking negative gearing and mortgages and $50k weddings and $20k wedding rings and private school fees, because let’s face it, deep down no-one likes that shit.

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I’m not really very good at dealing with needy people. Part of the reason is that I myself am an intense person. But I’m not enthusiastic because I have a weird crush on all my friends. I’m enthusiastic because I find things actually interesting or to be passionate about?

And so I collect needy people. And they tell me their problems. Which kind of inspires me to think that maybe I have these needy-people-problems myself. I don’t really care that I’m single right now but all the needy friends do, and so I find myself wondering if there’s something wrong with me.

Then I get anxiety about being single. Except, I don’t care about being single. I’m a little upset that I let myself put on so much weight and that the only people who are flirting with me are very strange. And I’m missing my cats and my friends up here. But being single? I’m only upset about that (in reality) in a sort of theoretical way. Sometimes I read something in fiction featuring being super happy and contented and in love and I feel wistful but that’s about it.

I had a crush on a friend who also likes THE LADIES recently. Anyway she wasn’t interested, which is kind of ok. I’m relieved. The amount of relief was kind of… excessive. But fair I guess since she lives a long way away? And I was so unbelievably anxious and stressed around that time (from moving and needy friends) that I think it was kind of all mushed up into that stuff.

I guess it highlights though just how easy it is to get self-delusional. Or to be oblivious? Who knows.

I haven’t really had time to update this thing, even though I’ve wanted to. I haven’t had enough headspace due to too many work hours. And once you haven’t updated something in awhile it gets harder and harder. But I’ve resigned my job and I’m now spending time travelling and catching up with people and working. So hopefully there will be more time devoted to writing.

Here are some of my current whinges:

OH DEAR GOD TONY ABBOTT. He is a scary extreme right wing sexual assaulting sociopathic narcissistic creeptard with a strategy that seems to aim towards making the country even more backwards and authoritarian than it already is.

I have a big and awesome idea and I’m finding it really difficult to connect to people on the same wavelength. Even the people I’ve kind of approached to help me with it… yes… they mostly have the same ideas as me but there are sticking points that irk me.

I’m too fat. I mean this entirely in a health sense.

People who should know better keep lecturing me about how my sense of style is ‘wrong’ and ‘not feminine’ because it isn’t the mainstream drag-queen-esque nonsense that passes for Australian ‘fashion’. They can get fucked.

People who should know better are intentionally misinterpreting or refusing to understand the gender fluidity thing which I have been explaining in as clear a way as possible. and I don’t really want to hang out with the ‘genderqueer‘ people because they seem kind of wanky.

I actually had this really awesome catch up with this awesome chick in another city I don’t live in and I’m quite attracted to her but it’s kind of frustrating because clearly this is not going to go down any sort of romantic path. Oh well.

The attitude towards education in this country and the way in which the system enforces class distinctions is utterly utterly messed up.

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Aaaand… this is why sex ed should be compulsory and should include discussion about consent.
Unhealthy, narrow-minded ideas about rape were certainly more common in the past and I hope they are improving, but there is a lot of work to be done. And educating kids & teens is a cornerstone.

Yesterday, the news invaded my classroom. I think the kids aren’t paying attention. I think the kids only care about the news as it relates to Justin Bieber. I think they aren’t listening or capable of advanced thought. Every single time I think one of those things, I sell out the ninth-graders that come traipsing through my room every day.

It started when I picked this poem to go over different ways to look at poetry:

Witness

Martha Collins

If she says something now he’ll say
it’s not true if he says it’s not true
they’ll think it’s not true if they think
it’s not true it will be nothing new
but for her it will be a weightier
thing it will fill up the space where
he isn’t allowed it will open the door
of the room where she’s put him away he will fill up her mind he…

Hmmm. Something about this book, and the website of the author (SociopathWorld) is not quite right. The descriptions are jaw-droppingly delicious, beautifully described, gorgeous, sexy, frightening and disturbing. It’s great writing, very compelling, and you are drawn right into the head of a sociopath.

What doesn’t seem right is that very style. It’s certainly grandiose and embellished, as any tale by a sociopath would be. However, is this the way that anyone describes their own life (such in their own memoirs)?

I suppose the answer is “sort of”- there are people (for example those who write their sexual exploits for XOJane, Jezebel, such as the odious Cat Marnell) who write in a version of that long narrative style. These people are generally histrionic, attention-seeking, rich, media savvy people who are also classic unreliable narrators. Did Cat Marnell really do coke off a stripper’s vagina at the age of 19 while being livestreamed doing DVDA porn in-between editing other peoples’ columns about eyeshadow or whatever it is she claims to have done? Who really cares? This category of internet columnist trolls are generally not particularly good writers and instead sell their work based on shock value, like a sort of disaster-porn.

The other group of people who tend to write beautiful, long prose about their lives as if it was a novel are… well… those who are writing fiction. Especially those who write hoax memoirs or blogs such as “Gay Girl in Damascus“. It’s amazing, actually, how well written some of it is, given its literary status as atrocity-porn-propaganda.

Generally what gives away the hoax memoirs (other than the authors not turning up to celebrity appearances) is also that while well-written, elements of the story are simply unbelievable, jarring, too dramatic. There’s a bizarrely compelling component to these strange details, like Anthony Godby Johnson being deliberately infected with HIV by his parents (neglect, sexual abuse, ‘punishment’ all make sense in terms of gain for the parents but deliberate infection with HIV does not- unless the gain is for the author).

So I suppose we wait with bated breath to see what the book is actually like.

Sociopathy has become a pretty hot topic lately- even more so than usual- with books such as Jon Ronson‘s “The Psychopath Test“, the release of DSM-V which has reinstated sociopathy as a personality disorder and quite the number of crime shows exploring the underlying psychology of those who commit heinous and serial crimes. With the increasing recognition of the “functional sociopath” – the rate of sociopathy in the business world is 4% or twice that in the general population (the rate is 50% in rapists) – what is missing is an account from the perspective of the sociopath. How do these strange, guiltless, empathy-less, superficially charming monsters think and behave?

In a world where there are many paths to publication but where it is still very difficult to do, a popular blog cum novel makes sense. If this book is indeed a hoax, I would bet that the writer is very intelligent, works in either the healthcare industry or academia (and is definitely university educated), is media-savvy and may have written works that were not published before.

ASMR or “autonomous sensory meridian response” (“the name that stuck” rather than “made up pseudoscientific name”, I think) refers to the ability of certain triggers to induce a state of intense relaxation combined with “chills”, “goosebumps” and pleasant tingling sensations often felt in the scalp and limbs.

I happen to have grapheme-colour synaesthesia, I have meditated and I have been hypnotised before, and unsurprisingly, I suppose, it turns out that I am sensitive to ASMR.

It’s not really a phenomenon that has been studied, certainly not in detail, so I’m unable to report on the underlying neuropsychological mechanisms. Instead, I can explain the sensations and the elements that I think make it work.

Common contents of the most popular ASMR videos on YouTube:

Quiet, monotone, melodious talking

Sounds such as pencil on paper, hairdryers, occasional traffic

The use of a scenario with a professional, non-sexual but personal and intimate theme such as a dental receptionist, a travel agent (although reassuring and more emotionally intimate scenarios also work)

Being in the right semi-sleepy mood, lying in bed and having music playing on random

Ironing bedsheets

Having a cat lick my hand

Having someone lick my ear (OMG)

So, what sorts of experiences would I say this feeling is similar to, that I have experienced before? Meditation, hypnotic trance, “flow”, physical intimacy and… synaesthesia. Thus this is what I speculate is happening:

The use of personalisation in the form of a human or animal, especially using close-ups of faces and eye contact, engages feelings of empathy and intimacy as well as establishing a “relationship” (remembering that our brains do simulate behaviour that we watch others do)

The “boring”/repetitive/innocuous vocal stimuli and noises are of the sort of quality that is used in hypnotism or in calming a child. It isn’t so repetitive that it is predictable, but it is also not striking enough to need or draw attention

The noises and “eye testing” or “hair cutting” scenarios have something in common- they invite synaesthetic sensations. Sounds such as fingernails tapping on a hard surface or a hairbrush scratching something like skin or pencil scraping against paper are related to and reminiscent of physical sensations- thus the “chills” and “goosebumps”

Finally, harmonious, complex tasks requiring concentration engage the feeling of flow and the somewhat repetitive but not-quite-boring feeling of “flow”.

Thus, the ingredients that are effective in these videos would be things such as a relaxed, calm, quiet, gentle protagonist, cross-sensory stimuli that are neither too boring/repetitive nor so interesting that they are frustrating or dramatic, and personalisation/intimacy without distracting features such as sexualisation.

I don’t think this is actually something that everyone can experience. The great popularity of seemingly mind-numbingly boring YouTube videos about not-very-much-at-all does suggest that it’s probably a somewhat common phenomenon, even if it’s something that seems bizarre when first described. Then again, so are meditation and hypnosis, which are well recognised phenomena with well recognised patterns of brain function and activation.

An interesting footnote is that the ASMR videos/sounds sent both of my cats into gentle purrs and then they fell into a relaxed sleep.

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If you’d asked the 16 year old me what I’d pick- a happy low-paid & lowly regarded job or a miserable highly-paid highly esteemed job- I would have had no trouble with answering that I’d want to be happy, not rich. And similarly if you’d asked young-me whether I thought it was possible to fall in love with and have an absolutely fulfilling romantic life with someone of a different social class and educational level I would have said that it was definitely possible.

And yet here I am, in a well-paid, stressful, highly competitive job with little to no spare time. And part of the time I’m happy, sure. But so much of that time is spent with heartache and stress. Scared I might kill someone. That my decisions might lead to a horrible outcome. That my bosses think I’m lazy or incompetent. That my career will be ended prematurely. And the worst and biggest fear is the silent voice in the back of my head saying:

“You are an imposter pretending to be hard-working and competent but one day someone senior is going to find out the truth and tell everyone.”

The thing is, it’s not paranoia because everyone really is out to get you. Waiting to see whether you will perform to the “required standard” to figure out whether you’re good enough to proceed. You have to watch your back because people will inevitably complain. And they will complain loudly, especially if they perceive you as weak or unlikeable. If you get a reputation then the shit will stick, and confirmation bias will mean that people will only notice the bad bits that conform to what they expect of you. The good things probably won’t be noticed because you’re meant to be doing them automatically anyway.

The worst thing of course is if people think you’re a liar, a whistle-blower or actually crazy. Those things will not just stick but they may follow you from job to job. Hushed warnings behind closed doors. Keep an eye on that one.

There is no guide and no-one teaches you how to be good at this. It’s sink or swim. Some people are naturally “good”. Much of that is about patterns of behaviour. Relaxed, articulate confidence. To be fair, most relaxed, articulate, confident people seem to be that way because they know what they’re talking about. Except there’s also over-confidence, manipulative behaviour or being a smooth talker whose knowledge is inadequate but whose blunders are quietly swept away.

No-one is perfect, but no-one wants to be the “problem child”. But how do you know you’re not a problem child, when one of the symptoms of being a problem child is lack of insight? If people favour confidence and frown upon signs of weakness then how do you know whether you’re the arrogant overreaching wanker or the calm confident competent übermensch? How do you ask for help?

What if you end up in the painful cycle of torment where someone has decided that you are a problem child and no matter what you do to improve, you are scrutinised so closely that any small mistake is seen as a massive failure, and confidence and lack of confidence are both seen as signs of being problematic?

This is basically the junk that follows you around all day at work and follows you home to haunt your sleep. At least the pay is good. It better be, considering the stress. Considering the cost of take-away food. New clothes because you’re getting fatter. Courses. Presents for the friends and family you never see. A cleaner maybe because you have no energy to clean the house.

And yet, somehow all that money gets spent. On stuff especially that you don’t really need. And on renting a place big enough to house all the stuff you don’t need.

Meanwhile even though you’re technically sane, you know you’re part of a crazy system with its own dysfunctional illogic that makes no sense unless you’re within it. People outside it don’t realise that no, there really is nothing you can do to improve things or bargain and yes, these terrible conditions really are meant to be “part of the job”.

It’s also self-perpetuating. How can you exist without the money, the prestige when you have little enough already? You can’t quit or take time off because everyone will think you’re “not coping” or that you’re a “quitter”, a “failure”, someone who didn’t fulfil their contract and left everyone else in the shit.

And see this is the other thing- everyone tells you that all your other options are equally as awful. There’s no way out! There really are no options other than to plod along! Everything is awful everywhere no matter what you do!

THERE IS NO ESCAPE.

I’m starting to think a different way. I’ve saved lives. I’ve changed the world for the better. I’ve made lots of money. I’ve been there, I’ve done that and I’m not even 30. So even though I don’t have a shit-load of savings, even though I haven’t achieved everything possible had I shotgunned the shortest possible journey to the top, maybe this is enough for now and maybe there is something better out there for me.

I am writing this letter because I feel that our leaders and lawmakers do not have an accurate picture of what it actually entails to become a physician today; specifically, the financial, intellectual, social, mental, and physical demands of the profession. This is an opinion that is shared among many of my colleagues. Because of these concerns, I would like to personally relate my own story. My story discusses what it took to mold, educate, and train a young Midwestern boy from modest roots to become an outstanding physician, who is capable of taking care of any medical issues that may plague your own family, friends, or colleagues.

I grew up in the suburbs of southeast Michigan in a middle-class family. My father is an engineer at General Motors and my mother is a Catholic school administrator in my hometown. My family worked hard and sacrificed much…

My dear friend and mentor, Deb shared the following piece she wrote with me. I asked her if I could share it here and she agreed. Deb is an amazing warrior woman, who is willing to help guide others and share her knowledge when appropriate or needed. Debra resides in the Peace Region of BC and is originally from Idaho.

“Government policies such as Indian Act, Residential Schools, and the 60’s Scoop was legalized genocide and acclamation of property. They were the vilest examples of legalizing genocide and dressing it up as “those poor backwards Natives, we got to help them fit into society.” Every single Act and piece of legislation was designed to break our culture and to liberate land and resources to “feed their need of greed.” I have no further to look than current affairs to see that this continues.